妊高征患者脐带胎盘病变与脐血流S/D比值和眼底检查的关系

为探讨妊娠高血压综合征 (简称妊高征 )时脐血管胎盘的病理学变化与脐动脉血流收缩期 /舒张期 (S/D)比值和眼底检查的关系。利用HE及特殊染色 (PTAH)的方法 ,光镜下观察 4 1例妊高征患者 (妊高征组 )和 2 3例正常晚期孕妇 (对照组 )的脐血管、胎盘形态学变化 ;使用彩色多普勒超声仪于产前测定妊高征组脐动脉血流S/D比值 ;眼科做眼底检查。按脐带血管胎盘病变的轻重程度将妊高征组分为无病变 ( 2例 )、轻度病变 ( 1 7例 )、重度病变 ( 2 2例 ) 3组 ;与轻度妊高征比较 ,中度和重度妊高征组脐血管胎盘病变逐渐加重 ;对照组未见明显脐血管胎盘病变。脐血管胎盘轻度病变者 ,脐动脉血流S/D比值均 <3。脐血管胎盘重度病变者中有 7例脐动脉血流S/D比值 >3,集中在重度妊高征组 ,提示脐动脉血流S/D比值与妊高征病情的严重程度相平行。妊高征眼底改变与脐血管胎盘病变趋于一致。提示 :脐血管胎盘病变能反映妊高征的基本病理改变 ,与疾病的严重程度成正比。脐血管胎盘病变与眼底检查、脐动脉血流S/D比值之间成平行关系。胎盘形态学改变较脐带明显

Relationship between Pathological Features of Umbilical Vessels and Placenta and S/D Ratio and Visual Disturbances in Pregnancy Induced Hypertension

The objective was to evaluate the relationship between the pathological features of umbilical vessels and placenta, the S/D ratio, and visual disturbances in pregnancy induced hypertension (PIH). The umbilical vessels and placenta of 41 women with PIH and 23 normal term-pregnant women (control group) were observed under light microscopy and a special staining method, doppler and ultrasound S/D ratio. The ophthalmologist examined the visual disturbances. Forty-one women with PIH were categorized into three groups according to the degree of lesions: no lesion (n=2), mild(n=17),and severe(n=22). The pathological changes of umbilical vessels and placenta in moderate and severe PIH were more severe than those in mild PIH(P<0.01). However, there were no apparent pathological changes in the control group. The pathological changes of umbilical vessels and placenta in PIH had a significant relationship with S/D ratio, and neonatal outcome . The pathological changes of umbilical vessels and placenta can reflect the characteristic lesion of PIH and are parallel with the severity of the disease. The pathological changes of umbilical vessels and placenta are parallel with the S/D ratio and the visual disturbances. The pathological changes of placenta are more severe than umbilical vessels.